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Our Own Worst Enemy

Contact Information

Email: kcms@me.com
Phone: 856-419-6856
Hours: By Appointment Only

Vital Stats

Kenneth Szwak, MHS, PA-C

Physician Assistant

Emergency Medicine
Family Medicine

State Licensed:
New Jersey

Board certification:

Professional memberships:

AAPA- Fellow member

SEMPA- Fellow member

Arcadia University
Faculty Appointment:
Clinical Preceptor

Drexel University
Faculty Appointment:
Clinical Assistant Professor

'Tis not always in a physician's power to cure the sick; at times the disease is stronger than trained art.  ~Ovid

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I have been pondering for quite some time our use and reliance on medical terminology as medical providers and specifically, its pitfalls. Granted, what I’m about to get on my soapbox about is not exactly new, it is something I feel the need to express my own view on. As medical professionals, why do we use complex medical jargon? To communicate patient specific issues between colleagues / consultants? Yes. To advertise one’s medical prowess (or at least prowess at memorizing)? I’m sure that happens. To verbally castrate a clinician one feels is far inferior? Alas, that does still happen from time to time. However, even the best of us forget to turn off our internal medical dictionary when talking to patient’s and/or family members, often leaving them with that glazed over, uncertain look even though they nod their head in understanding. Being on the side recently with my grandmother as a patient and hearing physicians talk to my family (not knowing my profession), I can honestly say some never turn that dictionary off. Much has been done in the way of trying to teach health care providers to speak to patient’s and family in a way that’s easy for them to understand, with varying degrees of success. However, how can we expect any real progress in that respect when we don’t even get it right between ourselves as clinicians?

What do I mean??? Take the good old case of sinus arrhythmia. We all know what it means, the naturally occurring variation in heart rate that occurs during a breathing cycle, yadda, yadda, yadda. And hopefully most of us know, or at least have heard, that the terminology is wrong or in the very least, very inaccurate. With any other medical terminology, putting “a” in front of a word basically means “without”. Afebrile means without fever, Asymptomatic means without symptoms. So basically arrhythmia means without a rhythm, which we all know is not the case. It would be much more accurate for the terminology to be changed to “sinus dysrhythmia”. And while I’m glad to say that I do hear some clinicians (cardiologists, internal medicine physicians, PA’s, NP’s) use that terminology, most stick to the old, very inaccurate terminology.

I’m sure there are many others that you as colleagues may have thought of on your own. Of late, I have been giving thought to receptive aphasia. I don’t argue the definition / underlying cause of the aphasia. However, even though it is rooted in the patient’s ability to understand what is being said or written to them and even though they can speak clearly, the end result is that the patient cannot properly express themselves. While I’m not suggesting we call this a type of expressive aphasia, calling it receptive is not all encompassing. For while pathophysiologically it’s an issue with the patient understanding incoming information, clinically, the patient still cannot express themselves. Since there are components of both, why not change the terminology to something that alludes to both sides of it, such as “translational aphasia” or “fluent aphasia” as I’ve sometimes read / heard it used.

The medical terminology we use (and love?) is necessary, perhaps a necessary evil at times. While we can’t just toss it away, we do need to be more conscious in the way we utilize it. We must take strides in improving misleading and accurate terminology that we use in communicating with each other in addition to improving the way we communicate with our patients.


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April 2013
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